MON-832 - Mortality Trends Related to Calcium Disorders in the United States from 1999-2023: A CDC WONDER-Based Analysis

Background:
Disorders of calcium homeostasis are common in endocrine practice and
associated with significant morbidity. However, long-term national mortality
trends related to calcium disorders in the US remain poorly characterized.

Methods:
We extracted mortality data from the CDC WONDER Multiple Cause of Death
database from 1999–2023. Deaths due to disorders of calcium metabolism
were identified using ICD-10 E83.5. Age-adjusted mortality rates (AAMR) were
calculated per 100,000 individuals using the 2000 U.S. standard population.
Joinpoint regression analysis was performed to evaluate temporal trends,
estimating annual percent change (APC) and average annual percent change
(AAPC). Statistical significance was defined as p< 0.05.

Results:
From 1999 to 2023, mortality due to calcium disorders increased significantly
overall (AAPC: +0.61%; 95% CI: +0.25 to +0.98). Mortality declined from 1999
to 2008 (APC: −3.49%) and increased significantly from 2016 to 2023 (APC:
+5.58%). Both sexes showed increases after 2016. Adults aged 75–84 years
demonstrated one of the steepest rises (AAPC: +2.10%), with acceleration after
2019. Across racial groups, mortality declined in earlier years and increased in
recent years, with the largest increases observed among American Indian and
Alaska Native populations (APC: +8.08% from 2014–2023). Non-Hispanic Black
individuals consistently exhibited higher mortality rates. Mortality increased
significantly in the Midwest (AAPC: +0.88%) and South (AAPC: +1.21%). Large
metropolitan areas experienced an overall decline (AAPC: −1.16%) while other
areas showed stable and late- increasing trends.

Conclusion:
Mortality related to calcium disorders increased after 2016, with accelerated
rises after 2019. Coronavirus disease 2019–related hypocalcemia, driven by
systemic inflammation, vitamin D deficiency, altered parathyroid hormone
signaling, and critical illness, may have contributed to excess mortality.
Persistently higher mortality among Black individuals may reflect physiologic
differences in calcium and vitamin D metabolism, compounded by
comorbidities and structural inequities, highlighting the need for targeted
endocrine interventions.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*